• World Neurosurg · Nov 2024

    Review

    Role of statins in the clinical and radiological outcomes of patients with unruptured intracranial aneurysm UNDERGOING ENDOVASCULAR TREATMENT; A systematic review and meta-analysis.

    • Mohammad Amin Habibi, Seyed Ahmad Naseri Alavi, Mohammad Sina Mirjnani, Aliakbar Aliasgary, Pouria Delbari, Muhammad Hussain Ahmadvand, Sina Hatami, Zuha Hasan, Adam A Dmytriw, and Andrew J Kobets.
    • Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
    • World Neurosurg. 2024 Nov 25.

    BackgroundThe impact of statin pretreatment on outcomes for patients undergoing endovascular treatment of intracranial aneurysms remains uncertain. We aimed to conduct a systematic review and meta-analysis evaluating the efficacy and safety of statins in this population.MethodsWe searched the PubMed/Medline, Embase, Scopus, and Web of Science databases from inception to August 1, 2024.This study compares the outcomes between statin users and non-users undergoing endovascular aneurysm treatment.ResultsA total of eight studies with 5,862 patients were included. Complete occlusion rates after ewasascular aneurysm treatment were similar between statin users and non-users (pooled OR 0.93, 95% CI 0.70-1.23). Statin use was associated with significantly increased risk of ischemic stroke (pooled OR 1.51, 95% CI 1.03-2.19, P-value: 0.03). No differences were seen in neurological mortality (pooled OR 0.74, 95% CI 0.21-2.57, P-value: 0.63), all-cause mortality (pooled OR 0.68, 95% CI 0.16-2.90, P-value: 0.61), or retreatment rates (pooled OR 0.76, 95% CI 0.35-1.66, P-value: 0.49). Statin therapy was associated with decreased hemorrhagic complication (pooled OR 0.45, 95% CI 0.24-0.85, P-value: 0.01), but did not impact thrombosis risk (pooled OR 1.28, 95% CI 0.68-2.40, P-value: 0.45) and statin use lowered in-stent stenosis (OR: 2.31, 95%CI: 1.51 - 3.52, P-value: 0.001).ConclusionsStatin pretreatment may lower risk of hemorrhagic complications and in-stent stenosis after endovascular aneurysm therapy but does not improve angiographic occlusion. An increased hazard of ischemic events was found. Further data is needed to validate these findings and clarify the role of statins in aneurysm patients undergoing endovascular procedures.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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